{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:24:37Z","timestamp":1787311477655,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T00:00:00Z","timestamp":1589846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["19411970300"],"award-info":[{"award-number":["19411970300"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      (\n                      <jats:italic>H pylori<\/jats:italic>\n                      ) treatment remains a challenge for penicillin\u2010allergic patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      To evaluate the efficacy and tolerability of susceptibility\u2010guided first\u2010line and rescue treatment in\n                      <jats:italic>H pylori<\/jats:italic>\n                      \u2010infected penicillin\u2010allergic patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Consecutive\n                      <jats:italic>H pylori<\/jats:italic>\n                      \u2010infected patients with penicillin allergy received a 14\u2010day triple or quadruple therapy based on susceptibility to clarithromycin, levofloxacin, and metronidazole. All received esomeprazole 20\u00a0mg twice a day. Metronidazole\u2010susceptible infections received metronidazole plus clarithromycin or levofloxacin triple therapy if susceptible. Clarithromycin\u2010 and levofloxacin\u2010resistant infections received metronidazole plus tetracycline triple therapy. Metronidazole\u2010resistant infections received a bismuth\u2014high\u2010dose metronidazole plus clarithromycin or levofloxacin quadruple therapy. Triple\u2010resistant infections received classical bismuth quadruple therapy with high\u2010dose metronidazole. Antimicrobial susceptibility was assessed using the E test method.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      112 patients were entered (34.8% men, average 47.1\u00a0years). Infections in 83.8% (31\/37) of treatment\u2010naive subjects and 12.0% (9\/75) (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001) receiving rescue treatment were susceptible to at least one of the three tested antibiotics. Overall, susceptibility\u2010guided therapy achieved eradication rates of 92.9% (104\/112, 95% CI 88.1%\u201097.7%) by intent\u2010to\u2010treat analysis and 99% (100\/101, 95% CI 97.1%\u2010100%) by per\u2010protocol analysis. All regimens achieved eradication rates greater than 90% (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.327) in the PP populations. Adverse events were relatively frequent; however, compliance remained high.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Susceptibility\u2010guided therapy proved highly effective for penicillin\u2010allergic patients. When available and proven locally effective, the alternative was empiric classical bismuth quadruple therapy. This trial is registered with ClinicalTrials.gov as NCT03708848.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hel.12699","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T17:29:08Z","timestamp":1589909348000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Susceptibility\u2010guided therapy for\n                    <i>Helicobacter pylori<\/i>\n                    \u2010infected penicillin\u2010allergic patients: A prospective clinical trial of first\u2010line and rescue therapies"],"prefix":"10.1111","volume":"25","author":[{"given":"Laisheng","family":"Luo","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Shanghai Institute of Digestive Disease Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Shanghai Institute of Digestive Disease Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Liang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Shanghai Institute of Digestive Disease Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7373-1053","authenticated-orcid":false,"given":"Yingjie","family":"Ji","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Shanghai Institute of Digestive Disease Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5328-6258","authenticated-orcid":false,"given":"Lou","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Shanghai Institute of Digestive Disease Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3127-6048","authenticated-orcid":false,"given":"Hong","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Key Laboratory of Gastroenterology and Hepatology Ministry of Health, Shanghai Institute of Digestive Disease Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13497"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312288"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12485"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2009.06.007"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2015.05.003"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-005-2549-1"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3365-2"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.05.028"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkv155"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12584"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.10.3138-3144.2003"},{"key":"e_1_2_8_13_1","unstructured":"The European Committee on Antimicrobial Susceptibility Testing.Breakpoint tables for interpretation of MICs and zone diameters. 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